Our Summary

This research paper looked at people who had surgery for hemorrhoids - a common condition where blood vessels in the rectum or anus become swollen and painful. The researchers wanted to find out how common it was for these patients to need a blood transfusion because of bleeding before their surgery. They also wanted to find out what factors increased the risk of needing a transfusion.

The study looked at a group of 520 patients who had this surgery between 2012 and 2017. They found that 7.3% of these patients had bleeding from their hemorrhoids that was severe enough to require a transfusion. Over 80% of the patients reported some bleeding.

The researchers found that using certain types of blood-thinning drugs increased the risk of needing a transfusion. People who needed a transfusion also had more extensive tests before their surgery, including different types of endoscopy - a procedure where a small camera is used to look inside the body.

The study concludes that the need for a transfusion due to bleeding from hemorrhoids is more common than previously thought and should be recognized more. This could lead to quicker surgical treatment and less expensive testing before surgery.

FAQs

  1. What is the prevalence of preoperative transfusion in patients undergoing surgical hemorrhoidectomy?
  2. What are the identified risk factors for transfusion in patients undergoing surgical hemorrhoidectomy?
  3. What types of preoperative workups did patients requiring transfusion have?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to avoid taking anticoagulants or non-aspirin antiplatelet agents before the surgery, as these medications can increase the risk of bleeding during and after the procedure. It is important to discuss all medications you are taking with your doctor before undergoing a hemorrhoidectomy to ensure a safe and successful outcome.

Suitable For

Patients who are typically recommended for hemorrhoidectomy include those who have severe symptoms that do not respond to conservative treatments such as dietary changes, fiber supplements, and topical treatments. Patients with large, painful, or thrombosed hemorrhoids may also be recommended for surgery. Additionally, patients with recurrent hemorrhoids or those who have complications such as bleeding, prolapse, or thrombosis may be candidates for hemorrhoidectomy. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the best course of action for their individual case.

Timeline

Before hemorrhoidectomy:

  1. Patients may experience minor gastrointestinal bleeding from hemorrhoids.
  2. Some patients may experience major hemorrhage requiring blood transfusion, though this is believed to be rare.
  3. Patients may undergo extensive preoperative workups, including colonoscopy, flexible sigmoidoscopy, upper endoscopy, and capsule endoscopy.

After hemorrhoidectomy:

  1. Patients may be at risk for bleeding requiring transfusion, with 7.3% of surgical hemorrhoidectomy patients experiencing this complication.
  2. Patients who require transfusion may have been using anticoagulants or non-aspirin antiplatelet agents.
  3. Increased recognition of bleeding requiring transfusion could lead to expeditious surgical treatment and less costly diagnostic workup.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hemorrhoidectomy surgery?
  2. Are there any alternative treatment options for hemorrhoids that I should consider before opting for surgery?
  3. How long is the recovery period after a hemorrhoidectomy, and what can I expect in terms of pain and discomfort during this time?
  4. Are there any specific dietary or lifestyle changes I should make before or after the surgery to improve my recovery?
  5. Will I need to take any medications after the surgery, and if so, what are they and how long will I need to take them for?
  6. How soon after the surgery can I resume normal daily activities, such as work and exercise?
  7. Are there any specific signs or symptoms I should watch out for after the surgery that may indicate a complication or infection?
  8. Will I need to follow up with you or another healthcare provider after the surgery, and if so, how often and for how long?
  9. Are there any long-term effects or complications that I should be aware of following a hemorrhoidectomy?
  10. Is there anything else I should know or consider before proceeding with a hemorrhoidectomy surgery?

Reference

Authors: Krebs ED, Zhang AY, Hassinger TE, Suraju MO, Berry PS, Hoang SC, Hedrick TL, Friel CM. Journal: Am J Surg. 2020 Aug;220(2):428-431. doi: 10.1016/j.amjsurg.2019.12.009. Epub 2019 Dec 6. PMID: 31932077